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NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 2/Question#31 (reveal difficulty score)
A 5-month-old boy is brought for a follow-up ...
Compression of the airway by a vascular ring ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: peds

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 +2  upvote downvote
submitted by โˆ—step_prep7(71)
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  • Patient has persistent wheezing despite treatment with bronchodilators, meaning that asthma is unlikely
  • 3 causes of chronic stridor/wheezing in a newborn/infant include laryngomalacia (inspiratory stridor/wheezing that worsens when feeding, crying or supine and improves when prone), vascular ring (biphasic stridor/wheezing that improves with neck extension) and airway hemangioma (worsening biphasic stridor over first year of life in patient with concurrent skin hemangioma)
  • Patients with proetin-induced allergic proctocolitis secondary to milk consumption often have bloody stools in setting of other allergic conditions (allergies, eczema or asthma)
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 +1  upvote downvote
submitted by โˆ—medicalmike(82)
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Vascular ring presents in infancy with biphasic stridor/wheezing that improves with neck extension. None of the other answer choices would persist for 5 months and still result in a happy, well-nourished baby.

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tinylilron  I did not choose this one because I thought a vascular ring compressing the airway would result in stridor... :-/ +
tinylilron  I did not choose this one because I thought a vascular ring compressing the airway would result in stridor... :-/ Also, is the baby not demonstrating esophageal symptoms because he is only fed formula at this time? +



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